Vertical Vergence Research Articles

Visually induced vertical vergence as a motion processing biomarker associated with postural instability

The present study explored visually induced vertical vergence (VIVV) as non-specific motion processing response. Healthy participants (7 male, mean age 28.57 ± 2.30; 9 female, mean age 27.67 ± 3.65) were exposed to optokinetic stimuli in an HTC VIVE virtual reality headset while VIVV, pupil-size, and postural sway was recorded. The methodology was shown to produce VIVV in the roll plane at 30 deg/s. Subsequent trials consisted of 40 s optokinetic motion in yaw, pitch, and roll directions at 60 deg/s, and radial optic flow; optokinetic directions were inverted after 20 s of motion. Median VIVV amplitude changes were normalized to the clockwise roll rotation, analysed, and correlated with changes in pupil-size and body sway. VIVV, pupil-size, and body sway were all affected by changes in optokinetic direction. Post-hoc analyses showed significant VIVV responses during optokinetic yaw and pitch rotations, as well as during radial optic flow stimulations. VIVV magnitudes were universally correlated with pupil-size and body sway. In conclusion, VIVV was expressed in all tested dimensions and may consequently serve as a visual motion processing biomarker. Failing to support binocularity while responding to optokinetic directionality, VIVV may reflect an eye-movement response associated with increased postural instability and stress, similar to a dorsal light reflex.

Temporal dynamics of ocular torsion and vertical vergence during visual, vestibular, and visuovestibular rotations.

Ocular torsion and vertical divergence reflect the brain's sensorimotor integration of motion through the vestibulo-ocular reflex (VOR) and the optokinetic reflex (OKR) to roll rotations. Torsion and vergence however express different response patterns depending on several motion variables, but research on their temporal dynamics remains limited. This study investigated the onset times of ocular torsion (OT) and vertical vergence (VV) during visual, vestibular, and visuovestibular motion, as well as their relative decay rates following prolonged optokinetic stimulations. Temporal characteristics were retrieved from three separate investigations where the level of visual clutter and acceleration were controlled. Video eye-tracking was used to retrieve the eye-movement parameters from a total of 41 healthy participants across all trials. Ocular torsion consistently initiated earlier than vertical vergence, particularly evident under intensified visual information density, and higher clutter levels were associated with more balanced decay rates. Additionally, stimulation modality and accelerations affected the onsets of both eye movements, with visuovestibular motion triggering earlier responses compared to vestibular motion, and increased accelerations leading to earlier onsets for both movements. The present study showed that joint visuovestibular responses produced more rapid onsets, indicating a synergetic sensorimotor process. It also showed that visual content acted as a fusional force during the decay period, and imposed greater influence over the torsional onset compared to vergence. Acceleration, by contrast, did not affect the temporal relationship between the two eye movements. Altogether, these findings provide insights into the sensorimotor integration of the vestibulo-ocular and optokinetic reflex arcs.

Concussed patients with visually induced dizziness exhibit increased ocular torsion and vertical vergence during optokinetic gaze-stabilization

Visually Induced Dizziness (VID) is a common post-concussion sequalae that remains poorly understood and difficult to quantify. The present study aims to identify biomarkers for VID in the form of gaze-stabilizing eye movements. Nine patients with post-commotio VID and nine age-matched healthy controls were recruited by physiotherapists at a local neurorehabilitation centre. Torsional and vergence eye movements were recorded while participants viewed a series of optokinetic rotations where the central- and peripheral regions moved coherently, incoherently, or semi-randomly. Results showed that vergence and torsional velocities were increased in VID patients, reflecting increased oculomotor gain to visual motion, and that responses correlated with symptom severity. Coherent stimulation produced fastest torsional slow-phases across all participants; when faced with confliction directional information, eye movements tended to follow the direction of the central visual field, albeit at slower velocities than during coherent motion, meaning that while torsion was sensitive to visual content of the entire visual field it expressed directional preference to the central stimulation. In conclusion, post-commotio VID was associated with faster slow-phases during optokinetic gaze-stabilization, with both vergence and torsion being correlated to symptom intensity. As torsional tracking remains inaccessible using commercial eye-trackers, vertical vergence may prove particularly accessible for clinical utility.

Investigation of Selective Innervation of Extraocular Muscle Compartments.

Recent magnetic resonance imaging studies have suggested that extraocular muscles (EOM) are further divided into transverse compartments that behave differentially and often unexpectedly during eye movements. Selective innervation of EOM compartments may explain the observation that certain horizontal recti compartments contribute to specific vertical eye movements and that some cyclovertical EOM compartments do not contribute to vertical vergence. We investigated the discharge characteristics of extraocular motoneurons during these eye movement tasks where EOM compartments behaved differentially for evidence of selective innervation. We recorded from all six extraocular motoneuron populations in the abducens, oculomotor, and trochlear nuclei as two non-human primates performed vertical vergence and vertical smooth-pursuit. The relationship between motoneuron firing rate, horizontal and vertical eye parameters of the innervated eye during each task was determined using multiple linear regression. All 26 medial rectus motoneurons recorded showed no significant modulation during vertical smooth-pursuit and vertical vergence. Twenty-eight of 30 abducens motoneurons showed no significant modulation during vertical vergence, and all 30 cells did not modulate during vertical smooth-pursuit. For the cyclovertical motoneurons, 147 of the 149 cells (44/46 inferior rectus, 27/27 superior oblique, 41/41 superior rectus and 35/35 inferior oblique) modulated significantly during vertical vergence. Extraocular motoneuron activity during vertical vergence and vertical smooth-pursuit does not support the theory that EOM compartments are selectively innervated. The observed differential behavior of EOM compartments is likely not driven by oculomotor control and could be due to passive change in EOM cross-sectional area.

Moderate Severity SARS-CoV-2 (COVID-19) Affects Ocular Vergence Indices: Eye Tracking-Based Study.

Since the start of the SARS-CoV-2 (COVID-19) pandemic, it has become clear that the brain is one of the main targets for acute and chronic damage. Although neurodegenerative changes have yet to be investigated, there is already a large body of data on damage to its fiber tracts. A mobile eye tracker is possibly one of the best tools to study such damage in a COVID hospital setting. At the same time, the available data indicate that eye tracking parameters, even in healthy volunteers, demonstrate a distinct gender-specific difference.The aim of the work is to evaluate functional and structural impairments of the fiber tracts and to find possible gender-specific dynamics of eye tracking indicators in the acute period of COVID-19 pneumonia (Delta variant) of moderate severity. A single-center non-randomized retrospective study included 84 patients in the acute period of moderate severity SARS-CoV-2 (COVID-19) pneumonia (Delta variant) (Group 1). The mean time from admission was 1.4±1.2days. M:41, F:43. According to thoracic CT, the lung involvement ranged from CT 1 to CT 2. SpO2 ranged from 95% to 99%. The mean age was 35.5±14.8years (from 18 to 60). The control group (Group 2) included 158 healthy volunteers without pathology of the vision organs and central nervous system.The eye vergence index (VRx) was determined using eye tracking as a motion correlation coefficient between the angular velocities of the left and right eyeballs and was a measure of the conjugation of horizontal and vertical eye movements.The mobile complex Eye Tracker Low-Speed 20 (BVG LLC, the Netherlands) was used. Eye tracking parameters were assessed by vertical and horizontal eye vergence (VVRx and HVRx).Statistical analysis was done using the methods of parametric and non-parametric statistics. Moderate COVID-19 pneumonia resulted in a significant decrease in both VVRx and HVRx compared to controls (0.763±0.127 and 0.856±0.043; p<0.000001; 0.729±0.018 and 0.776±0.023 p<0.000001, respectively). VVRx values were significantly higher in men (0.775±0.046 and 0.747±0.091, p=0.019, respectively), while ХVRx values were significantly higher in women (0.665±0.018 and 0.728±0.024, p<0.0000001, respectively). SARS-CoV-2 (COVID-19) of moderate severity is accompanied by a significant deterioration in eye tracking performance proving functional and structural impairments (p<0.05). VVRx was significantly higher in men, and HVRx was substantially greater in women reflecting gender-specific differences.

Spatial–temporal contrast sensitivity of the eye alignment reflex

The binocular alignment of the eyes involves both voluntary and reflexive mechanisms, but little is known about the visual input and neurological pathway of the reflex component. Our studies examined the role of spatiotemporal frequency and contrast in the control of reflex eye alignment, and compared the contrast sensitivity of the alignment reflex with psychophysical contrast sensitivity. We measured the contrast sensitivity of vertical disparity-driven vergence eye movements in response to bandwidth filtered static or 6 Hz counterphase flickering noise and measured psychophysical detection sensitivity for the same stimuli. Contrast thresholds for producing a detectable vertical alignment change (measured with nonius lines) were determined using a staircase method for 7 spatial frequencies [0.25–16 cycles per degree] and 3 vertical disparities [5, 10, and 30 arcmin] in 7 adults with normal or corrected to normal vision. The main findings of this study are, (1) the vertical alignment reflex had overall relatively high contrast sensitivity, comparable to but somewhat less than visual detection thresholds, (2) the most effective stimulus spatial frequency scaled in inverse proportion to the disparity being stimulated, and (3) unlike psychophysical contrast sensitivity, the eye alignment reflex contrast sensitivity was not improved by flickering low spatial frequencies.

How Lingering Fusional Adaptation Influences the Bielschowsky Head Tilt Test in Superior Oblique Paresis.

The lack of a positive Bielschowsky head tilt test (BHTT) is commonly seen as an indicator that superior oblique paresis (SOP) is not present. This study investigated the influence of fusion on the BHTT in unilateral SOP. We analyzed vertical fusional vergence using our eye-tracking haploscope and the value of BHTT difference (BHTTD) in 11 patients who were diagnosed with congenital unilateral SOP and able to fuse. Patients used one of three different mechanisms of vertical vergence to achieve fusion. The three fusional mechanisms were associated with a significantly different BHTTD (p < 0.05). Seven of the eleven patients used vertical recti-mediated fusion and had a mean BHTTD ± SD of 21.7 ± 6.3 prism diopters (PD). Three of these patients whom we measured after a patch test for at least 30 min showed a decreased BHTTD (12.7 ± 3.8 PD). Three of the eleven patients used a mixed (oblique/rectus) fusional mechanism and had a mean BHTTD ± SD of 9.3 ± 8.6 PD. Of these patients, the one whom we measured after patching showed an increase of 11 PD in BHTTD. The remaining patient used oblique muscle-mediated fusion and had a BHTTD of only 3 PD that increased to 21 PD after patching. One explanation for this BHTT behavior in the latter patient involves lingering vergence adaptation of the "paretic" superior oblique muscle (SOM) and contralateral inferior oblique muscle, which makes these muscles more effective when activated, as is the case on ipsilateral head tilt (part of the ocular counter-roll mechanism), lessening the expected increase in hyperdeviation. Similarly, in our patients with mixed fusion, the vergence-adapted "paretic" SOM and contralateral superior rectus muscle are activated on ipsilateral and contralateral tilt, respectively, lessening the hyperdeviation in both directions. In the other seven patients, however, the vergence-adapted ipsilateral inferior rectus muscle and contralateral superior rectus muscle are activated on contralateral tilt, accentuating the BHTTD. Depending upon the specific muscles used for vertical fusion, the BHTTD is decreased or increased. The presence of a large BHTTD points to lingering or persisting fusional tonus involving the vertical rectus muscles. The lack of a positive BHTT does not rule out the diagnosis of SOP, but rather may be caused by lingering or persevering fusional tonus involving the oblique muscles. Performing the BHTT after a patch test for a minimum of 30 minutes may be necessary to reveal the BHTTD, supporting the diagnosis of SOP.

Reduced activity of vertically acting motoneurons during convergence.

Previous studies have revealed unexpected relationships between the firing rates of horizontally acting motoneurons and vergence. During a vergence task, for example, antidromically identified abducens internuclear neurons show a negative correlation between vergence angle and firing rate, which is the opposite of the modulation displayed by the medial rectus motoneurons to which they project. For a given horizontal eye position, medial rectus motoneurons discharge at a higher rate if the eyes are converged than if the same eye position is reached during a task that requires version; paradoxically, however, the horizontal rectus eye muscles show corelaxation during vergence. These complex and unexpected relationships inspired the present author to investigate whether the tonic firing rates of vertically acting motoneurons in oculomotor nucleus are correlated with vergence angle. Monkeys were trained to fixate a single, randomly selected, visual target among an array of 60 red plus-shaped LEDs, arranged at 12 different distances in three-dimensional space. The targets were arranged to permit dissociation of vertical eye position and vergence angle. Here I report, for the first time, that most vertically acting motoneurons in oculomotor nucleus show a significant negative correlation between tonic firing rate and vergence angle. This suggests the possibility that there may be a general corelaxation of extraocular muscles during vergence.NEW & NOTEWORTHY An array of 60 plus-shaped LEDs, positioned at various locations in three-dimensional space, was used to elicit conjugate and disjunctive saccades while single neurons in oculomotor nucleus were recorded from rhesus monkeys. This study demonstrates that most vertically acting motoneurons in oculomotor nucleus discharge at a lower rate when the eyes are converged.

Large-scale cortico-cerebellar computations for horizontal and vertical vergence in humans

Horizontal and vertical vergence eye movements play a central role in binocular coordination. Neurophysiological studies suggest that cortical and subcortical regions in animals and humans are involved in horizontal vergence. However, little is known about the extent to which the neural mechanism underlying vertical vergence overlaps with that of horizontal vergence. In this study, to explore neural computation for horizontal and vertical vergence, we simultaneously recorded electrooculography (EOG) and whole-head magnetoencephalography (MEG) while presenting large-field stereograms for 29 healthy human adults. The stereograms were designed to produce vergence responses by manipulating horizontal and vertical binocular disparities. A model-based approach was used to assess neural sensitivity to horizontal and vertical disparities via MEG source estimation and the theta-band (4 Hz) coherence between brain activity and EOG vergence velocity. We found similar time-locked neural responses to horizontal and vertical disparity in cortical and cerebellar areas at around 100–250 ms after stimulus onset. In contrast, the low-frequency oscillatory neural activity associated with the execution of vertical vergence differed from that of horizontal vergence. These findings indicate that horizontal and vertical vergence involve partially shared but distinct computations in large-scale cortico-cerebellar networks.

OculoMotor Assessment Tool: Children Compared with Adults.

PurposeTo provide additional normative data for the OculoMotor Assessment Tool (OMAT) for horizontal and vertical saccades and vergence jumps and to compare the results of children to adults.MethodsParticipants with visual acuity of logMAR ≥0.0 (6/6) and Randot stereopsis of at least 250 sec of arc without binocular disorders were recruited. Horizontal and vertical saccades, near point of convergence (NPC), accommodation and vergence jumps were evaluated using the OMAT. Means and standard deviations were reported for all parameters in children and adults.ResultsA total of 52 participants (ages 9–34, mean age 17.5 ± 7.2 years) participated in this study. Statistically significant differences were found for horizontal and vertical saccades with lower mean results in children, aged 9–18 (111.5 ± 20.9 and 112.5 ± 22.7, respectively) compared to adults, aged 19–34 (131.6 ± 23.9 and 126.2 ± 24.2, respectively) (P = 0.002 and 0.04, respectively). The mean of the last 30 seconds of both horizontal and vertical saccades were statistically significantly lower in the children’s group (52.5 ± 10.6 and 52.1 ± 11.3, respectively) compared to the adults (63.2 ± 10.2 and 59.3 ± 13.4, respectively) (P = 0.001 and 0.04, respectively). The normative values for horizontal and vertical saccades were 119.6 ± 23.9 and 118.1 ± 24.1 saccades per minute, respectively. NPC break and recovery were 2.3 ± 2.3cm and 3.0 ± 3.3cm, respectively. The vergence jumps assessment was 79.3 ± 21.19 movements per minute.ConclusionNormative values for the OMAT test were found in this study for children and adults. Assessment of endurance found children norms significantly lower for horizontal and vertical saccades compared to adults.

Contrast Sensitivity of Vertical Vergence Eye Alignment

Purpose: The purpose of the study was to measure the response of vertical vergence eye movement to bandpass filtered noise of various spatial frequencies and contrasts. The results of our previous experiment in which we measured the contrast sensitivities using vertical vergence response to sine-wave gratings suggested that vertical vergence responses were robust for middle spatial frequencies (0.5 to 4 cycles per degree). However, the responses to higher and lower spatial frequencies were weaker. The weak responses at higher spatial frequencies could have been due to matching ambiguity of the gratings in the two eyes. So, to eliminate this ambiguity we used bandpass filtered noise as the stimulus to measure the contrast sensitivity of vertical vergence eye alignment. Methods: Subjects were 2 adults with normal vision. A Dual Purkinje image eye tracker was used for eye tracking. Vertical vergence was measured in response to full-screen bandpass filtered noise patterns of all orientations with one-octave bandwidth. A block of trials comprised combinations of 8 contrasts [0%, 1%, 2%,4%,8%,16%,32%,64%] and 8 spatial frequencies [0.125, 0.25, 0.50, 1, 2, 4, 8 ,16 cpd] presented in shuffled order. Various Oculometric functions (AUC, Percent Correct, Weibull fit, Vergence amplitudes) were created to determine the oculometric CSFs. The psychophysical CSF was obtained with a 2AFC staircase method for the same spatial frequencies using bandpass filtered noise patterns as stimuli. Results: Vertical vergence responses were robust for middle spatial frequencies. The responses for higher spatial frequencies were weaker or absent, similar to the results with sine-wave gratings. Conclusion: The results of this study suggest that matching ambiguity was not the primary limiting factor in the response of vertical vergence at higher spatial frequencies, despite being easily detected psychophysically. Further research is needed to understand why vertical vergence does not show a response at higher spatial frequencies.

Torsional component of microsaccades during fixation and quick phases during optokinetic stimulation.

While many studies have characterized the eye movements during visual fixation, includ-ing microsaccades, in most cases only horizontal and vertical components have been rec-orded and analyzed. Thus, little is known about the torsional component of microsaccades. We took advantage of a newly developed software and hardware to record eye movements around the three axes of rotation during fixation and torsional optokinetic stimulus. We found that the average amplitude of the torsional component of microsaccades during fixation was 0.34 ± 0.07 degrees with velocities following a main sequence with a slope comparable to the horizontal and vertical components. We also found the size of the tor-sional displacement during microsaccades was correlated with the horizontal but not the vertical component. In the presence of an optokinetic stimulus a nystagmus was induced producing a more frequent and larger torsional quick phases compared to microsaccades produced during fixation with a stationary stimulus. The torsional component and the vertical vergence component of quick phases grew larger with higher velocities. Addition-ally, our results validate and show the feasibility of recording torsional eye movements using video eye tracking in a desktop mounted setup.

Optokinetic stimulation induces vertical vergence, possibly through a non-visual pathway

Vertical vergence is generally associated with one of three mechanisms: vestibular activation during a head tilt, induced by vertical visual disparity, or as a by-product of ocular torsion. However, vertical vergence can also be induced by seemingly unrelated visual conditions, such as optokinetic rotations. This study aims to investigate the effect of vision on this latter form of vertical vergence. Eight subjects (4m/4f) viewed a visual scene in head erect position in two different viewing conditions (monocular and binocular). The scene, containing white lines angled at 45° against a black background, was projected at an eye-screen distance of 2 m, and rotated 28° at an acceleration of 56°/s2. Eye movements were recorded using a Chronos Eye-Tracker, and eye occlusions were carried out by placing an infrared-translucent cover in front of the left eye during monocular viewing. Results revealed vergence amplitudes during binocular viewing to be significantly lower than those seen for monocular conditions (p = 0.003), while torsion remained unaffected. This indicates that vertical vergence to optokinetic stimulation, though visually induced, is visually suppressed during binocular viewing. Considering that vertical vergence is generally viewed as a vestibular signal, the findings may reflect a visually induced activation of a vestibular pathway.

Functional Anatomy of Muscle Mechanisms: Compensating Vertical Heterophoria

Magnetic resonance imaging (MRI) of extraocular muscle function was used to evaluate the role of newly recognized mechanisms underlying compensation of large heterophoria by vertical fusional vergence (VFV). Prospective case series. At one academic center, 8 adults with large hyperphoria and supernormal VFV underwent MRI during monocular and binocular fixation of a centered, near target. Contractility of the rectus and superior oblique (SO) extraocular muscles in hypertropic and hypotropic eyes was determined from changes in posterior partial volume (PPV). Five of 8 patients could sustain binocular fusion in the scanner. In those patients, VFV corrected approximately 5-degree misalignment, approximately 5-fold greater than normal VFV. Vertical strabismus was compensated mainly by significant contractility of the lateral more than the medial compartment of the inferior rectus (IR) in both eyes (P < .005). The superior rectus (SR) and inferior oblique muscles had no significant contractile contribution, although the hypotropic SO relaxed significantly. The IR lateral compartment and SR medial compartment significantly co-relaxed when binocular fusion was attained from monocular target fixation (P < .01). Although VFV protects patients from small muscle imbalances over the lifespan, even enhanced VFV may be inadequate to avert diplopia. Compensation of hyperphoria by VFV is accomplished mainly by IR muscle relaxation in the hypotropic eye, principally in its selectively innervated lateral compartment, whereas the SO contributes little. Fusion involves compartmentally selective co-relaxation in hypotropic eye vertical rectus muscles. Taken together, these overall findings suggest a physiologic basis to prefer therapeutic surgical weakening of the medial IR in the hypotropic eye.

Visual Binocular Disorders and Their Relationship with Baropodometric Parameters: A Cross-Association Study.

The aim of this study was to establish a relationship between nonstrabismic binocular dysfunction and baropodometric parameters. A total of 106 participants underwent binocular vision assessment by evaluating horizontal heterophoria, horizontal and vertical fusional vergence ranges, and vergence facility. Posturography was measured using the FreeMED baropodometric platform. Among the variables that the software calculates are foot surface, foot load, and foot pressure. Our results showed that in the participants with positive fusional vergence (PFV) (near) blur and recovery values outside the norm, there are statistically significant differences between the total foot area (p < 0.05), forefoot area (p < 0.05), forefoot load (p < 0.05), and rearfoot load (p < 0.05), in all of the cases of left foot vs. right foot. In the group of subjects who did not meet Sheard's criterion (distance), that is, those with unstable binocular vision, there was a statistically significant difference (p < 0.01) between maximum left and right foot pressure. In conclusion, our results establish a relationship between nonstrabismic binocular dysfunctions and some baropodometric parameters.

Fusional Single Vision with Prism-induced Vergence Has More Influence than Diplopia on Postural Stability.

Prism-induced convergence and vertical vergence for maintaining binocular fusion induced postural instability to a greater extent than diplopic conditions. This finding has important implication in relation to postural control of patients with large exophoria or vertical phoria in optometric clinic. The purpose of this study was to examine whether binocular single vision with prism-induced horizontal and vertical vergence and diplopia might affect the static postural stability. Forty-two subjects with a mean ± standard deviation age of 23.79 ± 2.81 years were enrolled in this study. To simulate convergence and divergence, base-in and base-out (BO) prisms of 4 and 8 Δ were added, respectively. To simulate vertical vergence, vertical prism of 2 Δ was added in a trial frame that corrected for the subject's refractive error during far distance (6 m) gaze. The prism power necessary to break fusion in each subject was detected and applied to induce diplopia in horizontal and vertical directions. Indices of general instability and sway power were measured under visual conditions using Tetrax and compared with normal viewing without the prism. Correlations between general instability indices and the ranges of break point in convergence and divergence were analyzed. Postural instability was increased significantly when convergence induced by BO 4 and 8 Δ and vertical vergence induced by 2 Δ were stimulated. The correlation coefficient between ranges of BO break point and indices of general instability was -0.308 in the BO 4 Δ and -0.306 in the BO 8 Δ condition. Although binocular input is recognized as an important factor in postural stability, binocular input with excessively stimulated convergence and vertical vergence during a far distance gaze is a latent factor affecting postural stability. On the other hand, diplopia did not influence postural stability.

Vertical vergence in nonhuman primates depends on horizontal gaze position

ABSTRACTThe goal of this study was to compare vertical fusion capability at different orbital eye positions in normal nonhuman primates and attempt to use this information to isolate the extraocular muscles (EOMs) that mediate vertical vergence. Scleral search coils were used to record movements of both eyes as two normal nonhuman primates (M1, M2) performed a vertical vergence task at different horizontal eye positions. In a control experiment, M1 was also tested at different angles of horizontal vergence. To elicit vertical vergence, a 50° x 50° stimulus comprising a central fixation cross and random dots elsewhere was presented separately to each eye under dichoptic viewing conditions. Vertical disparity was introduced by slowly displacing the stimulus for one eye vertically. Vertical fusion amplitude (maximum disparity that the monkey was able to fuse) and vertical vergence (maximum difference in vertical position of the two eyes) were measured. Vertical fusion capability differed at different orbital eye positions. Monkey M1 had significantly smaller vertical fusion capabilities when the right eye (RE) was abducted than left eye (LE) while M2 had significantly smaller vertical fusion capabilities when the RE was adducted and LE abducted. M1 also showed greater vertical fusion capability for near gaze. M1 data suggested that the vertical recti mediated vertical vergence in the RE and the oblique muscles in the LE while M2 data suggested that the oblique muscles mediated vertical vergence in the RE and the vertical recti in the LE. The variable results within the same animal and across animals suggest that EOM involvement during vertical fusional vergence is idiosyncratic and likely a weighted combination of multiple cyclovertical muscles.

Nonstrabismic binocular dysfunctions and cervical complaints: The possibility of a cross-dysfunction.

The aim of this study is to establish a relationship between non-strabismic binocular dysfunction and neck pain. One hundred twelve participants underwent binocular vision assessment by evaluating horizontal heterophoria, horizontal and vertical fusional vergence ranges and vergence facility. The subjects were classified into two groups: binocular anomalies and normal binocular function. Neck complaints were measured with the Neck Disability Index, visual analogue scale, cervical range of motion, deep-flexor muscle activation score (AS) and performance index (PI). Our results showed that participants with low AS had significantly altered values of lateral phoria (near) (mean = -6.99 SD ± 6.96 PD) and PFV (near) blur (mean = 9.49 SD ± 5.45 PD) against those who presented normal AS (lateral phoria (near) mean = -3.64 SD ± 6.37 PD; PFV (near) blur mean = 12.84 SD ± 6.20 PD). In addition, participants with NFV (near) recovery outside the norm had a significantly lower right side-bending (mean = 35.63 SD ± 8.35 PD) than those within the standard (mean = 39.64 SD ± 9 PD). The subjects with binocular vision impairment showed a diminished response to the deep cervical musculature, with low AS and PI, as well as a tendency to suffer from cervicalgia of more than three months’ evolution and a lower range of motion.

Vertical disconjugacy during reading in dyslexic and non-dyslexic children

PurposeThe objective of this study was to explore vertical binocular coordination in dyslexic and non-dyslexic children during saccades and post-saccadic fixation period while reading a text. MethodsBinocular eye movements were recorded by an infrared system (Mobile T2®, SuriCog) in thirty-six dyslexic children from 7.3 to 13.6 years of age (mean age: 10.4 ± 0.3 years) who were asked to silently read a four-line text during binocular viewing. Data were compared to those of thirty-six age-matched non-dyslexic children. ResultsVertical disconjugacy during post-saccadic fixation was higher in dyslexic children with respect to non-dyslexic children group. Vertical disconjugacy was not age-dependent either for dyslexic children or for non-dyslexic children. ConclusionsThe poor binocular vertical coordination observed in dyslexic children while reading could suggest a deficiency in the cerebellum and/or extra-ocular muscles involved in vertical eye alignment. Moreover, the fact that this vertical binocular coordination was not age-dependent could be due to an abnormal eye position and/or to a dysfunction of midbrain structures involved in vertical vergences.

Évaluation d’une plateforme d’orthoptie numérique 3D

To compare standard orthoptic tests with a novel digital 3D orthoptic platform, 3DeltaEasy(©) from Orthoptica(®). This study tests the 3D digital orthoptics platform, 3DeltaEasy(©) from Orthoptica(®) and compares it to the corresponding standard orthoptic tests. This platform consists of a computer equipped with dedicated software, a video projector and 3D liquid crystal glasses. Three tests were compared: Wirt test, measurement of horizontal and vertical phorias, and the horizontal fusional amplitude in convergence and divergence. A total of 102subjects, 53males (52%) and 49females (48%), aged between 9years and 72years (mean age 33±16.4years) were examined at the ophthalmologic department of the Brest Hospital (France) and included in this observational cross-sectional study. Subjects recruited in this study were patients requiring orthoptic screening or therapy. Patients without their optimal visual corrections were excluded. All patients underwent both ophthalmological and orthoptic examination including Wirt fly stereotest with polarizing spectacles, cover tests to evaluate and measure the horizontal and vertical deviation of the lines of sight, horizontal vergence ranges using prism bar and their equivalent tests implemented in the digital 3D orthoptic tests 3DeltaEasy(©) from Orthoptica(®). All data were processed using MedCalc Statistical Software version 14.12.0 (MedCalc Software bvba, Ostend, Belgium). The main result of this study is that 3DeltaEasy(©) and the classical Wirt test are correlated (Spearman's coefficient of rank correlation: ρ=0.74; P<0.0001), cover tests are equivalent for intermediate and far vision (paired t-test; P=0.46and P=0.51), and horizontal and vertical vergence range are comparable for distance vision (paired t-test; P=0.34and P=0.94). New digital 3D tools could easily substitute for some orthoptic tests with better ergonomics. Eventually, by increasing the number of tests performed, it could substitute for nearly all tests.